Aging & Health A to Z
Care & Treatment
Some causes of hearing loss can be treated medically or surgically. However, most hearing loss in older adults is treated with strategies to improve communication, amplify the sound (such as hearing aids), or both.
Hearing Assistance Technologies
These devices include:
- Microphones and transmitter that you put close to the sound source (like your TV) to transmit the sound to a receiver and headphones or earpieces, usually wirelessly.
- Personal pocket devices that amplify sounds closest to you, such as conversation, while reducing background noise. The devices are about the size of a business card, with about 100 hours of battery life. You clip it onto your belt, slip it into a pocket, or wear it around your neck, where it transmits the sound to headphones or ear buds. These devices are hardwired.
- Telephone ringers, which increase the volume of telephone rings, or make the phone vibrate or flash a light. Text telephones are also available. Most are free to people who are deaf or have severe hearing loss.
Other hearing assistance devices include closed-caption televisions, and vibrating and flashing devices such as alarm clocks and timers, smoke alarms, doorbell alerts, and motion sensors. You can find many of these items through state agencies for people with hearing loss, or online.
Hearing aids are the most common amplification devices. They can improve your ability to understand speech, particularly soft speech and conversational loud speech. It’s best to get hearing aids in both ears because that helps you identify the direction of the sound and most important improves understanding in noisy situations. If you have only lost the hearing in one ear, you may only be eligible for one hearing aid, but there are now a variety of options for persons with single-sided deafness.
Although you can buy hearing aids from many sources, including online, you should work with an audiologist or other healthcare professional trained in audiology. This way, you can make sure you get the right hearing aid for your needs that is fitted and adjusted correctly.
Not everyone benefits from hearing aids and they do require gradual adjustment. Some people can’t tolerate the feeling of having something in their ear but the open-fit hearing aids which are now very common for those with mild to moderate hearing loss do reduce this sensation. Others may have so much damage that they still can’t understand speech. However, counseling that teaches communication strategies and aural rehabilitation in addition to hearing aids can optimize chances of success. So make sure you can return your hearing aid at no cost after a trial period. At the same time, don’t give up too soon! Your audiologist can often adjust the fit and settings to improve the comfort and sound quality.
A hearing aid is just part of the equation for improved hearing; the other half is a hearing rehabilitation program. This includes counseling regarding the benefits and limitations of hearing aids and suggestions for communicating with others. It is typically included in the cost of the hearing aid.
Of course, hearing aids can’t help if you don’t use them. Many older adults purchase hearing aids but then don’t use them or only them occasionally. Among the reasons:
- Problems manipulating the tiny devices with their hands.
- Amplification of background noise.
- Thinking the aid is not needed.
- Cost concerns:
- Medicare does not cover hearing aids or other listening devices, although some Medicare Advantage plans may offer them as an added benefit.
- Most private insurers also don’t cover hearing aids or other listening devices.
- Some state Medicaid programs may cover hearing aids, but the reimbursement usually does not cover the whole cost.
- Federal programs such as the Department of Veterans Affairs may pay for hearing aids, depending on your eligibility.
Background noise is another problem. Traditional hearing aids increase all sound, so noises like rattling papers, running water, or other conversations can be very distracting. Newer technologies use multiple microphones and digital signal processing to decrease background noise, which can significantly improve your ability to understand speech in noise and increase your satisfaction with the hearing aid. The majority of hearing aids today are digital and most include features to promote understanding in difficulty listening situations.
Choosing the Right Hearing Aid
There are numerous styles of hearing aids. The best style for you depends on:
- the amount of your hearing loss
- your desire for available features
- your motivation and ability to properly insert and use the hearing aid
The most popular hearing aids are the behind-the-ear followed by in-the-ear models. Hearing aids are customized to your particular hearing loss and lifestyle needs. You can also often get two or more programs within a single hearing aid. For instance, you could use one program when you’re in an environment with background noise; another when you’re in a quieter environment. The audiologist uses a computer to adjust ranges and balance for each program. Some of the newer hearing aids automatically adjust the volume to increase amplification of soft sounds without becoming too loud.
Some hearing aids include a telecoil, which detects the magnetic field produced by telephones that are compatible with hearing aids. The telecoil lets you listen on the telephone with less distraction from background noise. It can also be used with many assistive-listening devices and in public spaces which have hearing loops which are increasingly gaining in popularity. The downside is that strong magnetic devices such as computer monitors can produce interference. Still, a telecoil is a useful feature that you can add to your hearing aids without much additional cost.
Behind-the-ear hearing aids hang behind the ear and are connected directly to an earmold ( customized to fit your ear), or a dome which varies in terms of the amount of outer ear occlusion. These aids are more visible than in-the-ear models, but they are durable, easily adjusted, and easily repaired. Some behind-the-ear aids can also be connected to other assistive-listening devices such as telephone or television amplifiers.
In-the-ear hearing aids are smaller devices that are custom fit to your ear. For some, they are very difficult to adjust and maintain because tiny particles of skin or wax get into them and damage them. However, most behind-the-ear hearing aids and in-the-ear hearing aids now come with wax guards which minimizes the chances of blockage from wax.
A cochlear implant is an electronic device surgically implanted in your ear. It bypasses the damaged cochlear hair cells and transmits sensory impulses directly to the cochlear nerves. Cochlear implants are only used only in people with severe to profound hearing loss whose hearing doesn’t improve with hearing aids. They don’t restore normal hearing, but will help you hear environmental sounds and understand speech better, use a telephone and, they restore the enjoyment of music for many.
Having a cochlear implant surgery requires extensive testing before surgery and training after surgery. Most Medicare program and insurance companies cover the procedure.
Updated: March 2012
Posted: March 2012